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2019年冠状病毒病大流行期间美国商业保险覆盖的糖尿病成年患者的医疗服务利用和支出变化:初步研究结果

Changes in Utilization and Expenditures Among Commercially Insured U.S. Adults With Diabetes During the COVID-19 Pandemic: Preliminary Findings.

作者信息

Zhou Xilin, Lundeen Elizabeth A, Rolka Deborah B

机构信息

Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.

出版信息

AJPM Focus. 2024 Jun 19;3(5):100254. doi: 10.1016/j.focus.2024.100254. eCollection 2024 Oct.

Abstract

INTRODUCTION

People with diabetes were among the populations that experienced the most profound impacts during the COVID-19 pandemic. The authors estimated changes in healthcare utilization and expenditures for commercially insured adults aged 18-64 years with diabetes during the pandemic.

METHODS

Medical claims data were from IQVIA PharMetrics Plus. Linear regressions were used to estimate the changes in utilization (per 1,000 individuals) for inpatient stays, emergency room visits, physician office visits, and ambulatory surgery center procedures. Changes in expenditures, in total and out of pocket, were estimated using generalized linear models. Expenditures were adjusted to 2021 U.S. dollars using the Consumer Price Index.

RESULTS

Utilization was reduced significantly for all service types during the pandemic. Although the largest reduction occurred between March 2020 and May 2020, the decrease persisted throughout 2021. During March 2020-May 2020, ambulatory surgery center procedures were reduced by 4.7 visits per 1,000 individuals. The reduction ranged between 0.4 and 1.3 visits per 1,000 individuals subsequently. Expenditures declined for all service types during March 2020-May 2020. However, after May 2020, the reduction remained statistically significant only for physician office visits for all months, with varying changes in expenditures for other service types.

CONCLUSIONS

Healthcare utilization and expenditures reduced among commercially insured adults with diabetes during the COVID-19 pandemic.

摘要

引言

糖尿病患者是在新冠疫情期间受影响最为严重的人群之一。作者估算了疫情期间18至64岁商业保险覆盖的成年糖尿病患者的医疗服务利用和支出变化情况。

方法

医疗理赔数据来自IQVIA PharMetrics Plus。采用线性回归估算住院、急诊就诊、门诊就诊和门诊手术中心手术的利用变化(每1000人)。使用广义线性模型估算总支出和自付支出的变化。支出使用消费者价格指数调整为2021年美元。

结果

疫情期间所有服务类型的利用均显著减少。尽管最大降幅出现在2020年3月至5月,但下降趋势在2021年全年持续。在2020年3月至5月期间,门诊手术中心手术每1000人减少4.7次就诊。随后每1000人的减少幅度在0.4至1.3次就诊之间。2020年3月至5月期间所有服务类型的支出均下降。然而,2020年5月之后,仅门诊就诊在所有月份的减少仍具有统计学意义,其他服务类型的支出变化各异。

结论

在新冠疫情期间,商业保险覆盖的成年糖尿病患者的医疗服务利用和支出减少。

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